Chronic Ankle Instability and Pain: Diagnosis & Treatment

Essential Insights and Treatment Options

Ankle sprains represent the most common presenting orthopedic problem to emergency rooms. Furthermore, since a sprained ankle is so common, it is often mistreated or treated at home without proper care resulting in chronic ankle instability and associated secondary ankle problems.

Common Presenting Findings of Chronic Ankle Instability:

Looseness with giving way or giving out

Catching of the ankle

Locking

Pain along the arch tendon (posterior tibial tendon)

Pain along the outside tendon (peroneal tendon)

Swelling

Abnormal rotation of the foot over time

These findings are due to the ankle being loose and subsequent instability of the ankle causing secondary problems such as ankle tendon tears, cartilage damage or bone spurs. These secondary pain sources are more often the presenting complaint as the patient has gotten used to the loose ankle as a primary source of pain.

An MRI offers the best information. The ankle ligaments, tendons, cartilage and bone can be check. The information in an MRI is invaluable in checking the ankle and also for planning surgical procedures.

In rare cases a CT scan is used for additional information if a fracture or cyst in the bone is suspected.

Following examination and testing, a game plan for treatment is considered. We often will try conservative care such as bracing, injection therapy and physical therapy for mild cases, but in a majority of cases, there is a surgical problem that needs to be corrected.

In most cases, the triad of common injury and the source of greatest pain and problems is a combination of scar tissue formation, instability and peroneal tendon tear. This triad has been reviewed and multiple papers have been published on the topic by University Foot and Ankle Institute.

The underlying cause of this triad is initial ankle sprain resulting in ligament tear that is not well treated. Over time the ankle forms scar tissue due to the body trying to stabilize the loose ankle. The ligament tear and laxity of the ankle make the peroneal tendon work to hard trying to stabilize the ankle resulting in a tear of the tendon on the back of the ankle. Over time the patient develops chronic pain and weakness as the ligaments and tendons do not work as a whole

With proper work-up and testing and sound surgical planning, chronic ankle instability can be well treated with excellent outcomes. The recovery is about 6 weeks in a cast and about 3 weeks of physical therapy after the cast is removed. Patients are most often able to return to full activity with no restrictions and have full recovery to pre-injury level. We can help you recover from your ankle ligament tear injury.

Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as co-director of University Foot and Ankle Institute. He is Editor Emeritus of the international medical journal, Foot and Ankle Specialist.

Dr. Baravarian been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He servers as a consultant to the ATP (Association of Tennis Professionals) tour, multiple running organizations and several shoe manufacturers. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

Podiatrist Dr. Bob Baravarian is available for consultation at the Santa Monica, Sherman Oaks and UCLA Westwood offices.

Find us on Facebook

I've already told Dr. Campbell that I think he's great. He listens to his patients and has a very cool, low-key approach that is genuine and comforting.

Wendy V.

Very informative and helpful. Glad I went, as I now know how to help myself.

Anonymous

Dr. Campbell is a phenomenal podiatrist and surgeon!

Amanda S.

This is my second experience, first plantar fasciitis, now my Achilles, lucky me. :( I would not go anywhere else and my feet are glad. Both times I have totally avoided surgery and for the Achilles, I was REALLY con...

Steven L.

Really cares about his patients. Takes his time to find the problem, not a factory trying to get you in and out. So glad we found him.

Mike M.

I broke my foot while working on a film production. One of my friends told me about the Foot and Ankle institute. They provided a great treatment for my foot and I was pain free within a week. I would definitely recom...

I.S.

The staff up front, especially Michelle, was great with scheduling and billing issues. The therapy team, especially Suzanne and Kristel, were incredible (as usual). Everyone is always friendly and professional, and I ...

Kevin D.

My feet have been killing me for the past two months and I put off getting it checked out. I finally came to see Dr. Briskin and I regret nothing! My appointment time was mostly kept and he found the problem right awa...

Cynthia S.

My right foot had been very tender and very painful for about two months, when I went to see Dr. Breskin. He was able to diagnose it right away and start treatment. I have Plantar Fasciitis. He answers all questions ...

Penny L.

Customer service is great, doctors are awesome, and it's easy to get an appointment. My daughter went here when she broke her ankle. Excellent treatment!